Delayed Part B COVERAGE

[margostl]

I have a client that has left employer coverage 12/31/21 she's 65 turning 66 in April.
She's going to take her deceased husband Medicare benefits.When she received her MB card
her effective date was 07/01/201 -A, 07/01/22-B anyone else have this occur.? I enrolled her in
PDP, but explained that we would have to wait for Supplement.Also had her to call SS to find out why.

 

[vic120]

Because she did not file correctly as one retiring or having credible cov

She applied as one who just did not apply for part B on time as A late enrollment and she will also have a penalty

You should have her fix this right away

 

[margostl]

So I have told her to contact them asap, she's not sure how she filed.She's stuck on not wanting to take her own benefits and SS
at 70. Plans to go back to work.Getting Medicare benefits and SS
benefits confused

Thanks for the response

 

[LostDollar]

She's going to take her deceased husband Medicare benefits. .

?? Social security benefits?

Edit
My post crossed yours.
End edit

 

[vic120]

So I have told her to contact them asap, she's not sure how she filed.She's stuck on not wanting to take her own benefits and SS
at 70. Plans to go back to work.Getting Medicare benefits and SS
benefits confused

Thanks for the response

She should have filed with a section that is for an employer to fill out proving credible coverage

She does not have to collect SS payments to do this

 

[somarco]

Based on your post, it appears she applied during the GEP which is why Part B is effective 7/1.

As @vic120 observed, she was entitled to an SEP based on involuntary loss of coverage.

I have no idea how or if this can be fixed . . . perhaps Vic has had success getting this unwound.

She has (had) 2 months after loss of creditable coverage (Jan & Feb) to apply for Part B without penalty or delay. CMS-40B is the Part B application to be filed in conjunction with CMS-L564 (employer form). Those 2 forms allow her Part B to start earlier (March 1 in this case) and avoid the penalties.

Those forms need to be submitted NOW, before the end of February.



The Social Security Administration is accepting Medicare Part B enrollment applications online for working individuals who qualify for a Special Enrollment Period (SEP).
You may use this online enrollment application if you are age 65 or older and you currently have or had within the last 8 months, group health plan (GHP) coverage through your (or your spouse's) current employment.
https://secure.ssa.gov/mpboa/medicare-part-b-online-application/


Note When completing the CMS L564

• State on the form “I want Part B coverage to begin (MM/YY)”
  
  
• If possible, your employer should complete Section B.Upload the completed form when using the online application.
  
  
• If your employer is unable to complete Section B, please complete that portion on behalf of your employer without your employers signature and submit one of the following forms of secondary evidence:
  
  
  • income tax form that shows health insurance premiums paid;
    
    
  • W-2s reflecting pre-tax medical contributions;
    
    
  • pay stubs that reflect health insurance premium deductions;
    
    
  • health insurance cards with a policy effective date;
    
    
  • explanations of benefits paid by the GHP or LGHP; or
    
    
  • statements or receipts that reflect payment of health insurance premiums.
    

CMS 40B | CMS

 

[vic120]

Based on your post, it appears she applied during the GEP which is why Part B is effective 7/1.

As @vic120 observed, she was entitled to an SEP based on involuntary loss of coverage.

I have no idea how or if this can be fixed . . . perhaps Vic has had success getting this unwound.

She has (had) 2 months after loss of creditable coverage (Jan & Feb) to apply for Part B without penalty or delay. CMS-40B is the Part B application to be filed in conjunction with CMS-L564 (employer form). Those 2 forms allow her Part B to start earlier (March 1 in this case) and avoid the penalties.

Those forms need to be submitted NOW, before the end of February.



The Social Security Administration is accepting Medicare Part B enrollment applications online for working individuals who qualify for a Special Enrollment Period (SEP).
You may use this online enrollment application if you are age 65 or older and you currently have or had within the last 8 months, group health plan (GHP) coverage through your (or your spouse's) current employment.
https://secure.ssa.gov/mpboa/medicare-part-b-online-application/


Note When completing the CMS L564

• State on the form “I want Part B coverage to begin (MM/YY)”
  
  
• If possible, your employer should complete Section B.Upload the completed form when using the online application.
  
  
• If your employer is unable to complete Section B, please complete that portion on behalf of your employer without your employers signature and submit one of the following forms of secondary evidence:
  
  • income tax form that shows health insurance premiums paid;
    
    
  • W-2s reflecting pre-tax medical contributions;
    
    
  • pay stubs that reflect health insurance premium deductions;
    
    
  • health insurance cards with a policy effective date;
    
    
  • explanations of benefits paid by the GHP or LGHP; or
    
    
  • statements or receipts that reflect payment of health insurance premiums.

CMS 40B | CMS

Never had the issue

My thought is lifetime penalty If it were Me I would go down to SS with correct forms and plead with them to fix it

I assume it was just done and the effective date is not yet begun and the end date of cov is within 3 months

I would maybe say i was misinformed on how to apply

I am just guessing its worth a shot

Not saying it will work

Though you have some good suggestions as well

 

[somarco]

My reservation is, Part B has already been approved, even though not yet effective. I hear all govt agencies are short handed and experiencing delays . . . SS, IRS, etc.

I suggested applying online because many SSA offices are closed or only open a few hours per week. The office in Gainesville, GA (about 50 miles north) was open 5 days per week, normal business hours and no wait as of last fall. Now it is open 1 day per week and Barney Fife guards the door only letting one person in at a time.

Clients in Atlanta are told to make an appointment. Call today for an appointment a month from now.

Similar action when applying by phone. You call and are told that someone from SSA will call you back in a month.

These are "regular" T65 folks, not SEP.

Information below is anecdotal

Time to process application

Online - 3 to 6 weeks

By phone or mail - 5 to 8 weeks, perhaps longer

In person at SSA office - 3 to 6 weeks

 

[margostl]

Well the client called and the rep.@ ss informed her she did not file incorrectly and that she would not incur a penalty. He stated that because she didn't pre-enroll she could not have a 7/21 effective date for part B. That coverage would be 3months after she turns 66 -7/22.

This is confusing to me since I would think her part A wouldn't require enrollment and the date would be 4/1/21. and part B, 4/1/22 Her dob 4/56 .I do know some working individuals have to activate their benefits, but I am unaware of why .She just applied in February for B received the card last week. I have not spoken to her yet, but hoping she got a name.

 

[Helpico_Insure]

Based on your post, it appears she applied during the GEP which is why Part B is effective 7/1.

As @vic120 observed, she was entitled to an SEP based on involuntary loss of coverage.

I have no idea how or if this can be fixed . . . perhaps Vic has had success getting this unwound.

She has (had) 2 months after loss of creditable coverage (Jan & Feb) to apply for Part B without penalty or delay. CMS-40B is the Part B application to be filed in conjunction with CMS-L564 (employer form). Those 2 forms allow her Part B to start earlier (March 1 in this case) and avoid the penalties.

Those forms need to be submitted NOW, before the end of February.



The Social Security Administration is accepting Medicare Part B enrollment applications online for working individuals who qualify for a Special Enrollment Period (SEP).
You may use this online enrollment application if you are age 65 or older and you currently have or had within the last 8 months, group health plan (GHP) coverage through your (or your spouse's) current employment.
https://secure.ssa.gov/mpboa/medicare-part-b-online-application/


Note When completing the CMS L564

• State on the form “I want Part B coverage to begin (MM/YY)”
  
  
• If possible, your employer should complete Section B.Upload the completed form when using the online application.
  
  
• If your employer is unable to complete Section B, please complete that portion on behalf of your employer without your employers signature and submit one of the following forms of secondary evidence:
  • income tax form that shows health insurance premiums paid;
    
    
  • W-2s reflecting pre-tax medical contributions;
    
    
  • pay stubs that reflect health insurance premium deductions;
    
    
  • health insurance cards with a policy effective date;
    
    
  • explanations of benefits paid by the GHP or LGHP; or
    
    
  • statements or receipts that reflect payment of health insurance premiums.

CMS 40B | CMS

A similar situation: My clients insist ( a couple), that they never got their Part A card, and now we can't go ahead with their Part B application. What I can do on behalf of them? They can't explain well why they don't have such a card.